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RESEARCH PRODUCT

Castleman's disease presenting as fever of unknown origin: diagnostic value of fluorodeoxyglucose-positron emission tomography/computed tomography.

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Abstract: Castleman's disease is an uncommon lymphoproliferative disorder that can present in both nodal and extranodal sites. The cause is unknown, but a disordered immunoregulation, which results in the excessive proliferation of B lymphocytes and plasma cells in lymphoid organs, plays a central role in the development of the condition. Three distinct histologic types (hyaline vascular, plasma cell, and mixed), and 2 anatomical variants (localized and multicentric) have been described. Clinical presentation generally consists of enlargement of lymph nodes or other tissues, fever, asthenia, weight loss, and other general symptoms, associated with nonspecific blood analysis abnormalities, such as acute phase reactant elevation and polyclonal hypergammaglobulinemia. We report an especially intriguing case of fever of unknown origin which could not be diagnosed despite numerous diagnostic tests over a prolonged period of time. Eventually, findings in an F18-Fluorodeoxyglucose-positron emission tomography/computed tomography scan allowed diagnosing Castleman's disease.